From: Jeffrey Epstein <[email protected]> To: Subject: Fwd: Research Date: Thu, 07 Mar 2013 21:56:43 +0000 Forwarded message From: Ting, Jess <1 a Date: Tue, Feb 19, 2013 at 6:30 PM Subject: Re: Research To: Jeffrey Epstein <[email protected]> Our research is based on the hypothesis that it is the micro-environment (e.g., the "normal" breast tissue surrounding a breast cancer in the case of breast cancer) that enables tumors to metastasize - rather than something intrinsic to the tumors. There is much anecdotal evidence to support this and it also explains several paradoxes about breast cancer - for example, why extirpative surgery for breast cancer seems to cause a paradoxical rise cancer activity. This theory which is known as the "seed and soil" hypothesis has been purely theoretical in the past because until now there was never way to study the microenvironment around these tumors without killing the host or killing the tissue itself. We came up with the idea to use fluid that is routinely collected (but thrown away) for 1-2 weeks after breast surgery as a proxy for the microenvironment around the tumor. Let me explain - after breast surgery to remove a cancerous breast, we routinely place a plastic drainage tube in the wound bed which exits the skin and drains excess blood and wound fluid into small plastic reservoirs. This prevents buildup of unwanted blood and fluid after surgery. This fluid is thrown away. The drains are kept in for a week or two. Our idea was that this fluid contains all the proteins, growth factors, cytokines, DNA transcription factors etc that are secreted by the cells around a cancer and would make an ideal way of studying the microenvironment in vivo. For the last three years, we have been collecting wound fluid for the first 48 hours after breast cancer surgery. We compare fluid in the same patient from the cancerous breast to the non-cancerous breast and from the cancerous breast to the abdomen.